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Sam Avery knew she could find what she needed at the All Families clinic, because she’d seen the protesters outside when driving through town. Their “Pray to End Abortion” signs billboarded an otherwise discreet service in Kalispell, Montana, population 22,000. It’s the kind of town where churches outnumber supermarkets and gay pride parades draw counter-protests. The clinic’s owner had a nickname: “Susan Cahill the baby killer,” says Avery. “She’s got that label for the rest of her life.”

Avery got pregnant after quitting the hormonal birth control that was making her sick. She decided to get an aspiration abortion, one of the most common surgeries in the U.S., which takes between three and 10 minutes to complete. Avery’s drive to All Families took four hours from her then-home on the Blackfeet Indian Reservation through Glacier National Park and across the Continental Divide. When she finally met Cahill, she gleaned a different impression from others in town: “She’s a rare mix of badass and surly and also caring and understanding. She has the right proportions to be really good at what she did.”